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Meta-analysis of Tripterygium wilfordii Hook F in the immunosuppressive treatment of IgA nephropathy Chen YZ; Gao Q; Zhao XZ; Chen XM; Zhang F; Chen J; Xu CG; Sun LL; Mei CLIntern Med 2010[]; 49 (19): 2049-55OBJECTIVE: Numerous Chinese patients with IgA nephropathy (IgAN) have benefited from Tripterygium wilfordii Hook F (TwHF) from two decades ago. However, to date there is no systematic evaluation of this remedy for IgAN. METHODS: We conducted a meta-analysis of all eligible randomized clinical trials (RCTs) to assess the effect of TwHF on IgAN for the first time. In August 2009 a systematic search was performed among eight electronic databases. Review Manager (RevMan) version 5.0 was used. RESULTS: (i) Four eligible RCTs with 188 participants were included; (ii) The validities of included RCTs were generally acceptable; (iii) TwHF brought about a favorable increase in complete remission (CR) (RR 1.53, 95%CI 1.09 to 2.16, I(2)=12%) and total remission (TR) (RR 1.27, 95%CI 1.08 to 1.48, I(2)=0%) compared with non-TwHF treatment; and this result was further confirmed by intention-to-treat analysis; (iv) Exploiting subgroup meta-analysis, TwHF led to significantly greater improvements of IgAN with non-nephrotic proteinuria with regard to the increase of CR (RR 1.80, 95%CI 1.21 to 2.68, I(2)=0%) and TR (RR 1.32, 95%CI 1.11 to 1.57, I(2)=0%), and decrease of urinary proteinuria excretion (UPE) (MD -467.41 mg/24h, 95%CI -633.99 to -300.82, I(2)=0%). Meanwhile, the renal function was well preserved (MD -2.66 micromol/L, 95%CI -9.26 to 3.94, I(2)=0%). Conclusion Although the results of this meta-analysis should be interpreted with caution and warrant further investigation, TwHF was certainly a valuable and promising immunosuppressive remedy for IgAN, which was in accordance with the accruing evidence from numerous large clinical and experimental studies.|*Phytotherapy[MESH]|*Tripterygium[MESH]|China[MESH]|Drugs, Chinese Herbal/adverse effects/*therapeutic use[MESH]|Female[MESH]|Glomerulonephritis, IGA/*drug therapy/immunology/physiopathology[MESH]|Humans[MESH]|Immunosuppressive Agents/adverse effects/*therapeutic use[MESH]|Male[MESH]|Randomized Controlled Trials as Topic[MESH]|Remission Induction[MESH]|Treatment Outcome[MESH] |
